Superficial
dermatophytosis is a commonly encountered infective dermatoses in clinical
practice. The incidence of dermatophytosis has increased in India over the past
decade, with the reported prevalence ranging between 6.09% and 61.5%. There has
been a rise in the incidence of chronic, relapsing and recurrent
dermatophytosis.
Dermatophytosis
is usually most often seen in postpubertal age, except for tinea capitis, and men
are usually more frequently affected than women. However, the scenario is
changing now. People from the lower socioeconomic status continue to be more
prone to develop the infection. Those involved in outdoor activities in hot and
humid environments have an increased risk of infection. Rampant, irrational use
of topical steroids and combination creams seems to be tied to the increasing
cases of chronic and recalcitrant dermatophytosis. Additionally, there has been
an epidemiological shift with Trichophyton mentagrophytes replacing T. rubrum
as the predominant organism.
There have been
several changes in the clinical presentation of superficial dermatophytosis in
India. These include sudden appearance and rapid spread of lesions, early
involvement of distant areas, varying degrees of inflammation, spread to family
members, eczema/dryness after infection causing persistent itch, flare up of
lesions with increased inflammation after starting treatment, concomitant
bacterial infections and chronic dermatophytosis, recurrences, relapses
becoming common.
It is not
necessary to see the well-defined, centrifugally spreading lesions with central
clearing now. The morphology of lesions has been changing with common forms
seen now including steroid-modified tinea, double-edged tinea, eczematous
lesions and tinea that mimics other dermatoses.
The involvement
of several body sites is common. Superficial dermatophytosis now involves
unusual locations such as genital dermatophytosis, superficial dermatophytosis
of scalp skin, Tinea auricularis, Tinea labialis, Tinea blepharitis and
ciliaris, and Tinea of vellus hair.
Itching is a
prominent feature of superficial dermatophytosis. There is often disabling
itch, with frequent aggravation at night. Itch may persist after lesions
resolve.
In conclusion, superficial dermatophytosis now occurs regardless of age, sex, climatic changes, and educational or socioeconomic status. There is a high rate of transmission among family members and close contacts. Chronic, recurrent and relapsing dermatophytosis is also increasing.
Reference
Verma SB, Panda S, Nenoff P, et al. Indian J Dermatol Venereol Leprol 2021;87:154-75.
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